Association between rotavirus gastroenteritis and intussusception: suggested evidence from a retrospective study in claims databases in the United States

ABSTRACT

The etiology of intussusception (IS), a serious gastrointestinal obstruction, remains unclear. Limited evidence suggests a role for viral infection. We investigated the risk of IS after rotavirus gastroenteritis (RV GE) in the first year of life. In this retrospective, self-controlled case series (SCCS), we assessed the risk of IS after RV GE using data from United States administrative claims databases. Incidence rate ratios (IRR) of IS were calculated for the 7- and 21-day risk periods after RV GE (main analysis) or after fracture (sensitivity analysis). A total of 290,912,068 subjects were screened; 42 presented claims for RV GE and IS, and 66 for fracture and IS. The IRRs of IS after RV GE were 79.6 (95% confidence interval, CI: 38.6–164.4) and 25.5 (95% CI: 13.2–49.2) in the 7- and 21-day risk periods. The sensitivity analysis showed an association between IS and fracture for both periods, suggesting potential confounding. Post-hoc analyses did not confirm the association between fracture and IS but suggested a potential association between RV GE and IS. A temporal association between RV GE and IS was detected using claims databases. Due to some limitations of the data sources, this association should be further investigated.

KEYWORDS:

• Rotavirus gastroenteritis
• intussusception
• self-controlled case series
• claims databases

Acknowledgments

The authors would also like to thank Vincent Bauchau, Paola Pirrotta and Tina Singh for the support provided during the study design and/or results interpretation.

The authors also thank Emmanuelle Ghys (Modis, Belgium c/o GSK) for publication management and Sara Rubio (Modis, Belgium c/o GSK) for providing medical writing support.

Disclosure of potential conflict of interest

BC, CW, EA, VV, and CC are employed by and hold shares in the GSK group of companies.

Data sharing statement

The data that support the findings of this study are available from Truven Health MarketScan Commercial Claims and Encounters and from Optum Clinformatics Data Mart, but restrictions apply to the availability of these data. The data were used under license and so are not publicly available.

Additional information

Funding

This work was fully supported by GlaxoSmithKline Biologicals SA, which was the sole funding source and was involved in all stages of study conduct, analysis, and interpretation. GlaxoSmithKline Biologicals SA took responsibility for all costs associated with the development and publishing of the present manuscript.